Wang Yanchi, Gu Jian, Zhang Feng, Xu Xujuan
Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), Nantong, Jiangsu, PR China; School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China; Department of Nursing, Affiliated Hospital of Nantong University, Nantong, Jiangsu, PR China.
Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, PR China.
Midwifery. 2025 Feb;141:104272. doi: 10.1016/j.midw.2024.104272. Epub 2024 Dec 18.
During pregnancy, prenatal anxiety is one of the most common mental disorders that women experience. This study aims to assess the prevalence of prenatal anxiety among Chinese pregnant women and explore the parallel mediating role of resilience and sleep quality in the relationship between self-efficacy and prenatal anxiety.
Between February and June 2023, a total of 1071 pregnant women were recruited from three hospitals in Nantong, Jiangsu Province, China, using a convenience sampling method. The participants completed general survey questionnaires and were assessed using the Depression Anxiety Stress Scale-21, the Pittsburgh Sleep Quality Index, the 10-item Connor-Davidson Resilience Scale, and the Chinese version of the General Self-Efficacy Scale. In addition, a hierarchical multiple regression analysis was employed to investigate the relevant and mediating factors of prenatal anxiety. This study utilized a structural equation model to examine the mediating role of resilience and sleep quality in the relationship between self-efficacy and prenatal anxiety.
Multivariate regression analysis showed that self-efficacy, resilience, and sleep quality were associated with prenatal anxiety (P < 0.05). The results of the mediation analysis indicated that resilience and sleep quality acted as fully mediators between self-efficacy and prenatal anxiety. The mediating effect of resilience was -1.8970 (95% CI -2.5259 to -1.3145), accounting for 72.07% of the total effect, and the mediating effect of sleep quality was -0.5482 (95% CI -0.7450 to -0.3726), accounting for 20.83% of the total effect. While self-efficacy accounted for 7.10% of the total effect (P = 0.5625), resilience, and sleep quality fully mediated prenatal anxiety.
In Chinese pregnant women, the study revealed that sleep quality and resilience played a fully mediating role in the impact of self-efficacy on symptoms of prenatal anxiety. This suggests that enhancing resilience, improving sleep quality, and promoting self-efficacy may help alleviate symptoms of prenatal anxiety.
孕期，产前焦虑是女性经历的最常见精神障碍之一。本研究旨在评估中国孕妇产前焦虑的患病率，并探讨心理韧性和睡眠质量在自我效能感与产前焦虑关系中的平行中介作用。
2023年2月至6月，采用便利抽样法，从中国江苏省南通市的三家医院招募了1071名孕妇。参与者完成一般调查问卷，并使用抑郁焦虑压力量表-21、匹兹堡睡眠质量指数、10项Connor-Davidson心理韧性量表和中文版一般自我效能量表进行评估。此外，采用分层多元回归分析来研究产前焦虑的相关因素和中介因素。本研究利用结构方程模型来检验心理韧性和睡眠质量在自我效能感与产前焦虑关系中的中介作用。
多元回归分析表明，自我效能感、心理韧性和睡眠质量与产前焦虑相关（P<0.05）。中介分析结果表明，心理韧性和睡眠质量在自我效能感与产前焦虑之间起完全中介作用。心理韧性的中介效应为-1.8970（95%CI -2.5259至-1.3145），占总效应的72.07%，睡眠质量的中介效应为-0.5482（95%CI -0.7450至-0.3726），占总效应的20.83%。虽然自我效能感占总效应的7.10%（P = 0.5625），但心理韧性和睡眠质量完全中介了产前焦虑。
在中国孕妇中，该研究表明睡眠质量和心理韧性在自我效能感对产前焦虑症状的影响中起完全中介作用。这表明增强心理韧性、改善睡眠质量和提高自我效能感可能有助于缓解产前焦虑症状。
